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Introduction

The Tele-consultation product of company MphRx is called Minerva and it has been available since 2010. The solution providers value cost reduction the most . Their business model is B2B, and also have white labelled products. They provide both mobile (android and iOS) applications for the doctors. They also provide mobile applications for patient and/or web based patient portals.

Size of Healthcare Provider

The solution is useful for the following categories of healthcare providers: 

a) Clinics

b) Nursing Home/Small Hospital (less than 100 beds)

c) Large Hospital

Level of Specialization

The solution can be used in the following settings of specialisation of clinical services:

a) Tertiary care

Expert Panel Evaluation

This teleconsultation solution provides facility to doctors to interact with patients in only synchronous manner. The solution provides multimode interaction i.e., audio and video. Doctors could interact with patients using audio and video calls. In order to take detailed notes, doctors have to close the video screen and then record diagnosis and assessment. This solution could enable basic clinical workflow in terms of writing subjective details and objective clinical diagnosis along with assessment and planning; including writing treatment/medication and other investigations as and when required. Doctors can take private notes. Doctor could edit notes during consultation, and 30 min post consultation. E-signature and digital signature integration is possible.

Formulary of drugs provided by the hospitals is used only for generating prescription for consultation. Providers shared that third party integration with the hospital HIS is done and follows FHIR standards for communication. This solution provides APIs that could be integrated in hospital HIS.

Patient’s control over data is decided at the hospital. This solution facilitates consent for every consultation.

Solution Maturity Level

a) TPG compliant: 3b

b) Feature complexity: 4 (Partial)

Introduction

The Tele-consultation product of company K2 Health Services Private Limited is called Prefr and has been available since March 2020. Their business model is B2B. They provide mobile applications (Android & IOS) for the doctors. They do not provide any application for patients.

Size of Healthcare Provider

The categories of healthcare providers that this solution can cater to are

a) Individual Clinician

Level of Specialization

The solution lends itself to use in the following levels of clinical specialisations (Follow-ups):

a) Primary care

b) Secondary care

c) Tertiary care

Expert Panel Evaluation

This tele-consultation solution validates registration details of doctors either manually or via support staff. Doctors can interact with patients only in a synchronous manner. This is more suitable for follow-up consultation as there is no application for patients. The solution provides multimode interaction i.e., video, audio and chat (using WhatsApp). This tele-consultation solution has a feature that enables doctors to take an image of their handwritten prescription, and it is advised that doctors use paper with the header having their details. Image is shared with patients using a link over WhatsApp and SMS. Doctor’s side application provides features of sharing prescription images by converting into PDF and adding doctor’s details as a header.

Doctor’s side of the interface has facilities to manage appointments, calendar scheduling, rescheduling appointments. There is no data capture and exchange standards integration present in the solution. It also considers application usage as consent i.e., implicit consent. 

Solution Maturity Level

a) TPG compliant:  3a

b) Feature complexity:  3a

Introduction

The Tele-consultation product of company Remedo Clinitech Private Limited is called Remedo Clinitech  and it has been available since 2016. The solution providers value cost reduction the most. Their business model is B2B2C and also has an option of white labelling the product.

Size of Healthcare Provider

The categories of healthcare providers that this solution can cater to are:

a) Individual clinician

Level of Specialization

The solution lends itself to use in the following levels of clinical specialisations:

a) Primary care

Expert Panel Evaluation

Doctors have their own profile page there and the link to that page is required for booking appointments by the consulting patients (Send the link to patient, link is for doctor is profile). In terms of compliance, application providers have mechanisms associated with the platform to validate registration details of doctors either with the help of the support team, oral confirmation by doctor, manual (personal) confirmation. Patients appointments are shown on the page, and records are accessible to share with other doctors. Patients can book appointments with the doctor only when the doctor adds the patient into the platform. A patient cannot search for a doctor on the platform. The patient needs to know the doctor’s URL to consult the doctor. This URL can be shared by the patient to other parties who can in turn use it to book an appointment.

The platform requires doctors to switch between multiple applications including web and mobile for consultation, video calling and note taking. Doctors are not having the option to minimize video in the user interface. The url of doctor-patient interaction can be accessed on a web interface for parallel working using a combination of web+mobile devices. Doctors can interact with patients in only synchronous manner and only video interaction is available during the consultation. Post Consultation the doctor can choose to keep a chat channel open for the patients to ask their queries (this chat could be paid and controlled by a doctor, post consultation). During the consultation, a chat option is not available. multi party consultation not possible.  Doctors are expected to click images and upload images of hand written prescription. Note taking is in SOAP format i.e., complaint, examination and drugs, and then prescription. They also have an EMR (Electronic Medical Record) feature and can add digital record for patients. Both doctor and patient could initiate the call, one time reminder can be sent by both also. They have a facility to customize the master drug formulary and then doctor wise personalization is done. There is rule based learning of the doctor’s previous consultation pattern, it is more like suggestions from individual doctor’s formulary. Doctors could simply share the record of a patient with another doctor (consent is not taken from the patient, considered implicit). Patients have control over first time sharing records on their platform, but once shared with doctors they can share across without consent. Video recording is not allowed. 

There are two versions for platform solutions for doctors. In case of proprietary EMR integration, prescription is generated with e-signature (or scanned signature) that is embedded in the document. Without EMR, doctors can issue prescriptions by clicking images and uploading the same.  Doctors could customize care specific programmes for example chronic condition management. There are multiple health programs available where the doctor can add the patient to any health plan such as pregnancy care plan, diabetic care plan etc. Awareness videos and health updates are available for the patient in the health plan program.

Application UI has English and Hindi options. Rural reach of solution is enabled because of providing audio calling facility (tele masked number to make call is shared with patient) and link of prescription is included in SMS to patient (URL is send, it remains active for a week), SMS link becomes inactive after that expiration period, but it is available on cloud storage at provider’s end. Care-giver (dependant)– family profile option is there, and main members of the family can access records and manage records. Family members can be added using separate phone numbers and all details are accessible to the main profile owner / manager. Multiparty or group calls are not possible. There is an option for the patient to give feedback after the consultation.

No standards have been implemented as recommended by EHRSI-2016 and NDHB. No health data exchange standard supported. Basic security standards are implemented like encrypted connection and role based login (access control). Consent is implicit everywhere.  

Additional Features

The solution also ensures following features:

a) Dependant / family profiling ( on the same account) 

b) Multilingual

Solution Maturity Level

a) TPG compliant: 3a 

b) Feature complexity: 3b [Partial]

Introduction

The Tele-consultation product of company NETMEDS MARKETPLACE Limited is called Netmeds and it is available from 2019. The solution providers value improved care delivery the most. Their business model is B2C and also has an option of white labelling the product. They provide both mobile and web based applications for the doctors. They also provide mobile applications for patient and/or web based patient portals.

Size of Healthcare Provider

The categories of healthcare providers that this solution can cater to are:

a) Individual clinician

Level of Specialization

The solution lends itself to use in the following levels of clinical specialisations:

a) Primary care

Expert Panel Evaluation

The platform has  an  easy to use interface for doctors. They have the speciality specific rules engine in the backend for case report preparation from the patient’s reported history. This case summary (history) is available to doctors. This platform supports basic clinical workflow (SOAP format) of teleconsultation. Type of interaction is not synchronous as note taking is in a separate tab along with video consultation.  The supported prescription format  is scanned, and within application the basic template of note taking. In case of platform generated prescription scanned  signature is added. There is no feature to record the doctor patient interaction/ consultation. No alerts are there to the doctors. 

The platform is easy to use for patients. The platform has a premium and basic subscription business model for the customers. Premium subscription patients can choose a doctor and book appointment for others (dependents), and can upload the documents. In the basic subscription patients have to search a specialty doctor for booking appointments. During onboarding, Patient is shown instructions on preparing for a video call. Doctor registration details and profile is shown to patients. After appointment,  booking patients are asked to provide history, clinical symptoms and signs.

Prescriptions are sent as email, so patients can access and download from there. Prescription is uploaded and a link is shared with the patient (Active for 48 hours). Patients can chat with doctors and the chat window remains active for 48 hours. The 24X7 support team is there, doctors and patients both can access it. PHR (Personal Health Record)  not there and smartphone use is mandatory. 

There is no feature to do multiparty calling and  cross referral cannot be done. Application is not multilingual. Premium  members can  add family members and book appointments for them on their behalf. The platform provides facility to initiate refund to patients in case of appointment cancellation. Patients can rate and provide feedback about doctors. 

In terms of compliance, application providers have mechanisms associated with the platform to validate registration details of doctors with the help of support teams. Consent is implicit as is part of terms and conditions. Audit trail  is there but data is stored without encryption. Proprietary EMR integration is facilitated.

Additional Features

The solution also ensures following features:

a) Proprietary EMR integration

b) Rule Based Information to prepare case reports (for history)

Solution Maturity Level

a) TPG compliant: 3a [Partial]

b) Feature complexity: 3b [Partial]

Introduction

The Tele-consultation product of company MFine is called MFine and it has been available since 2017. The solution providers value care delivery the most. Their business model is B2B and B2C both. They provide both mobile and web based applications for the doctors. They also provide mobile applications for patient and web based patient portals. They also offer white labelling options for the solution.

Size of Healthcare Provider

The categories of healthcare providers that this solution can cater to are:

a) Individual Clinician

b) Clinics

c) Nursing Home/Small Hospital (less than 100 beds)

d) Large Hospital

Level of Specialization

The solution lends itself to use in the following levels of clinical specialisations:

a) Primary care

b) Secondary care

c) Tertiary care

Expert Panel Evaluation

Doctors are given training while onboarding. The doctors’ credentials are verified manually and through the partner hospitals. The platform has  an  easy to use interface for doctors. In order to provide good consulting experience to patients, the doctor’s side of the interface has facilities to manage appointments, calendar scheduling and seamless appointments because of the waiting room facility (queue management). Platform has an admin role to support in managing consultation schedules.

The platform also supports performance of doctors in terms of time-efficiency by providing a user interface which requires minimum clicks and has easily navigable screens.  Note taking is guided data entry, with suggestions based on previous usage. The application is easy to use for patients.  Doctors can interact with patients in a synchronous manner; The solution provides multimode interaction i.e., audio, video, text and SMS. Doctors could interact with patients using audio/video call while simultaneously taking notes i.e. noting clinical condition, writing prescription  and/or entering data concurrently. This platform supports basic clinical workflow and specialty specific note taking in terms of writing subjective details and objective clinical diagnosis along with assessment and planning. Recording of consultation is not facilitated.

Platform has a feature that enables doctors to take an image of their handwritten prescription, preferably with the header having their registration details and it is shared with patients. Doctors are supported with quick prescription writing by rule based access to frequently used (favorite) drugs. Alerts for drugs and allergies are shown. Platform supports system generated   prescriptions with doctor’s registration details (without the doctor’s signature). 

The platform has interfacing with the drug database (CIMS) but does not have a feature to automatically restrict usage of schedule X / restricted drugs. The clinician has to manually check for restricted drugs in the prescription. There is notification of drug allergies and drug to drug interaction by pop up during consultation. Prescription is shared with the patient and uploaded in the patient’s account for future use. 

Patient side of the interface provides login for booking appointments, keywords based doctor search facility, speciality specific guided searching of doctors based on symptoms (rules based). Platform also allows them to take appointments on behalf of family members / loved ones. Patients have the facility to upload documents and enter vitals which doctors can access. Patients can also set reminders and alerts for appointments and medication. Patients can arrange their records and catalogue it. Frontend is multilingual with translation at the user interface. Smart phones are essential to be able to use this solution. Application supports multi party calling making it suitable for simultaneous  cross-consultation with  multiple doctors in the call  (for multidisciplinary care and discussions).  Application  also facilitates sharing case records (referral) by providers through sharing of referral doctor’s links to the patient. Patients have control over sharing and accessing their records. Platform provides facility to initiate refund to patients in case of appointment cancellation. Patients are having features to rate and provide feedback about doctors.

The platform has provision to exchange data (HL7 FHIR) It is claimed that the solution provides CDSS for diagnosis through symptoms and supports ICD-9/10 codes. Audit trail is maintained and data is anonymized for analytics. Transactional data is stored without encryption. Compliant with ISO 27001 and SHA 256 bit encryption.

The patient agrees to use the platform by a one time consent to terms & conditions while onboarding. For every doctor patient interaction, there is either just an implied consent (patients making the call) or there is a verbal chat based consent before the start of consultation. There is no explicit consent. There is no separate consent to use the patient data for purposes of use for AI.

Additional Features

The solution also ensures following features:

• CIMS Database integration
• CDSS for diagnosis 
• Integration with third party EMR of hub hospital 
• PHR
• Patient side Delight features
  • Medicine reminders
  • Quick follow up, 
• Doctor side features
  • Offline/Online availability settings
  •  Quick notes taking.

Solution Maturity Level

a) TPG compliant: 3a  

b) Feature complexity: 5  [Partial]

Introduction

The Tele-consultation product of company MedTrail Technologies Private Limited is called My Healthbook and it has been available since 2017. The solution providers value clinical outcomes the most. Their business model is B2B and also has an option of white labelling the product. They provide both mobile and web-based applications for the doctors. They also provide mobile applications for patients.

Size of Healthcare Provider

The categories of healthcare providers that this solution can cater to are:

a) Individual Clinician 

b) Clinics 

c) Nursing Home/Small Hospital (less than 100 beds)

Level of Specialization

The solution lends itself to use in the following levels of clinical specialisations:

a) Primary care

b) Secondary care 

c) Tertiary care

Expert Panel Evaluation

The platform has an easy to use interface for doctors and has features to support clinical consultation workflows for doctors during teleconsultation.  Doctors customize the profile page and that includes consultation appointments along with  payment type & options, and they can share this page across social media platforms for booking appointments with them. It is a product predominantly for doctors and gives more flexibility to doctors in terms of scheduling the appointment and managing the patient calls. The patient can only call at the pre-allocated time and if doctors are not free the patient is expected to wait for doctors. While the doctor could call before and after scheduled time as well. Automatic call is triggered to both doctor and patient. Doctors can use systems without much technology competency (digitization of hand written records is a facility in the features).

The platform provides asynchronous multimode interaction i.e., audio, video, chat post consultation. Doctors are required to switch the screen or close video calling before giving prescription and taking notes. Platform also has a drawing pad facility to explain to the patients with illustrations. Doctors have the option of uploading the click image of a prescription or writing on a digital pad (which is a separate integrated into this solution). Since the prescription is written on a digital pad, there is no template for it. Prescription on digital pad is converted into digital form. Patient gets a digitized prescription. The prescription is verified by a senior pharmacist. Patients get a digitized copy of prescription (only medication and diagnostic test), digitized copy of prescription is sent to doctor for validation before sharing with patient. They are using machine learning for verification and image to text conversion. If a specific segment cannot be digitized the doctor is required to correct the prescription before it is shared with the patient. There is no feature on the platform to check prescription  of restricted drugs, it has to be done in the manual verification stage by doctors. 

Patients can manage their profile, upload details before consultation but not during consultation. Concurrent chat facility is not available. However,  Doctors could chat with patients, post consultation. A patient cannot search for a doctor on the platform. The patient needs to know the doctor’s URL to consult the doctor and it can also be shared among patients to book an appointment. In short, the patient needs to know the doctor’s URL to fix an appointment with the doctor. Every patient login requires an OTP. They get an SMS from the call center number indicating the helpline number for support. Multi party calling is not there. It allows people to take appointments on behalf of family members/loved ones using the URL and only if the doctor adds the patient to the solution. It also facilitates features where doctors can share educational / promotional contents. Currently there is no option to create a family profile or caregiver profile.

The solution has provision to exchange data. ICD-10 for diagnosis and LOINC for lab tests has been implemented. HL7 messaging standard is implemented to exchange data with other applications. Security standards like encrypted connection, access control, digital certificate etc. are implemented.

In terms of compliance, a patient has to agree to terms and conditions before registering into the system, but no consent is available for every encounter. 

Additional Features

The solution also ensures following features:

a) Patient education templates are available.

Solution Maturity Level

a) TPG compliant: 2

b) Feature complexity: 4 [Partial]

Introduction

The Tele-consultation product of company KreativSARG Technology Solution LLP is called HelloDox and it has been available since 2018. The solution providers value care delivery the most. Their business model is B2B and B2C both, They provide both mobile and web based applications for the doctors. They also provide mobile applications for patient and/or web based patient portals.

Size of Healthcare Provider

The categories of healthcare providers that this solution can cater to are:

a) Individual Clinician

b) Clinics

c) Nursing Home/Small Hospital (less than 100 beds)

d) Large Hospital

Level of Specialization

The solution lends itself to use in the following levels of clinical specialisations:

a) Primary care

Expert Panel Evaluation

The application is easy to use for patients. Patients could search doctors by name, specialty and hospital name also. Patient could book audio only calls. Appointment notifications are sent half an hour prior to the appointment and reminders are sent even just before the appointment. The application is multilingual. Marati and English are the available languages. Doctors are required to be technology efficient in mobile usage. Doctors have to finish video consultation and then write diagnosis and prescription, the platform does not support synchronous interaction and communication. Doctor gets a summary of information compiled as a chat with the patient, doctor control audio, video interactions. Doctors could customise prescription templates. Notes writing is SOAP format dividing prescription into investigation, lab tests, medication and followed by instructions. Doctors can write the prescription in Marati and upload images. The prescription generated online via platform is  in English. Prescriptions generated by the platform do not contain a signature. Multi party and group calling facilities are not available. 

Patients can share (and upload) medical data through mobile application. Patients are required to enter medication, pre condition, pre allergies details are included as part of the patient profile. Multiple profiles can be created as part of the main user profile (family account).  Access to prescription is possible via the application’s chat interface. Prescription trail is also viewed only in chat form. This chat cannot be deleted. 

It is claimed the SNOMED CT is integrated in the software for symptoms, and provisional diagnosis. Platform provider also claimed that the server used to deploy the application is HIPAA compliant. 

Patient signs the consent only once during the time of registering into the system (platform usage during download). If the caregiver is using the solution on behalf of the patient, they have to upload consent. 

Additional Features

The solution also ensures following features:

a) Multilingual (vernacular Marathi & English)- partial.

Solution Maturity Level

a) TPG compliant: 2

b) Feature complexity: 3a [Partial]

Introduction

The Tele-consultation product of company IOTA Informatics Private Limited is called DigiQure and it is available from 2018. Their business model is B2C and also has white labelled products. They provide web based mobile responsive applications for the doctors. They also provide mobile applications for patient portals.

Size of Healthcare Provider

The categories of healthcare providers that this solution can cater to are:

a) Individual Clinician

b) Clinics

c) Nursing Home/Small Hospital (less than 100 beds)

Level of Specialization

The solution lends itself to use in the following levels of clinical specialisations:

a) Primary care

Expert Panel Evaluation

The provider has a mechanism to validate registration details of doctors either with the help of support team and manual (personal) confirmation of ID/credentials with support team, validation from state/ national doctor’s registry of doctor’s ID/credentials, mobile number. The platform has an easy to use interface for doctors and has features to support clinical consultation workflows for doctors during teleconsultation. The application is easy to use for patients as well. The platform is also usable by people not having smart phones for tele-consultation as SMS links for appointment and prescription (active for two hours) are shared. 

Doctors can interact with patients in both synchronous and asynchronous manner. The platform provides multimode interaction i.e., video/audio, chat, SMS. Doctors could interact with patients using audio/video call while simultaneously taking notes i.e., noting clinical conditions, writing prescriptions and entering data concurrently. This platform supports basic clinical workflow in terms of writing subjective details and objective clinical diagnosis along with assessment and planning including writing treatment/medication and other investigations as and when required. Doctor’s side application provides features of sharing prescriptions that have a doctor’s registration ID and scan  image of doctor’s signature. Payment gateway has wallet features for patients that is useful for credit based marketing. 

The patient’s side of the interface provides login for booking appointments. It has keywords, speciality and name based doctor search facility.  Patient gets a link to access prescription records. Patients have the facility to upload documents and enter vitals during consultation also which doctors can access. Platform also allows patients to take appointments on behalf of family members/loved ones. 

Platform has an admin role to support in taking consent before every consultation encounter, managing consultation schedules, and provides facility to initiate refund to patients in case of appointment cancellation. Audit trail maintains encryption of data and storage is there. 

Unique Features

The solution also ensures following features:

a) SMS link (smart phone not mandatory)

b) Translation of prescription (Hindi)

Solution Maturity Level

a) TPG compliant:  3b 

b) Feature complexity: 4 (partial)

Introduction

The Tele-consultation product of company India Health Link Private Limited is called hPod and it is available from 2019. The solution providers value clinical outcomes the most. Their business model includes both B2B and B2C.

Size of Healthcare Provider

The categories of healthcare providers that this solution can cater to are:

a) Individual 

b) Clinician

Level of Specialization

The solution lends itself to use in the following levels of clinical specialisations:

a) Primary care

Expert Panel Evaluation

The platform requires basic technology proficiency from doctors and patients to navigate applications/screens. They have modules to train and onboard the doctor.

Doctors cannot interact with patients in synchronous manner as the screen of the video call is separate from the note taking window. Doctors can chat during video consultation and upload/share documents with patients and chat can be done only after  initiating a video call. This platform supports basic clinical workflow in terms of writing subjective details and objective clinical diagnosis along with assessment and planning. Interface feature for medication and other investigations order is multiple-click. The platform provides integration with generic drug databases (proprietary drug formulary). Restriction on drugs is possible.

In order to provide good consulting experience to patients, the doctor’s side of the interface has facilities to manage appointments, sending reminders via email and provides a facility to initiate cancellation. 

Prescription is shared with the patient and uploaded in the patient’s application account for future use. Patient gets a link/email to access prescription records. They also have contacts with local pharmacies to facilitate home delivery of medications. 

Providers claimed that the solution is HIPAA compliant. No other data storage and exchange standards are supported. Doctors can take explicit video call consent (terms and condition of use) for patients for every tele-consultation session. Patients can provide feedback for teleconsultation.

Unique Features

The solution also ensures following features:

a) Integration with kiosk

Solution Maturity Level

a) TPG compliant:  3b

b) Feature complexity:   3b

Introduction

The Tele-consultation product of company PalmPower India HHA Private Limited is called PalmPower Medicus and it has been available since 2016. The solution providers value clinical outcomes the most. Their business model is B2B. They provide both mobile and web based applications for the doctors. They also provide mobile applications for patient portals.

Size of Healthcare Provider

The categories of healthcare providers that this solution can cater to are:

a) Individual Clinician

b) Clinics

c) Nursing Home/Small Hospital (less than 100 beds)

d) Large Hospital

Level of Specialization

The solution lends itself to use in the following levels of clinical specialisations:

a) Primary care

b) Secondary care

Expert Panel Evaluation

Doctors can interact with patients in a synchronous  manner. The platform provides multimode interaction i.e. video and chat. Doctors could interact with patients using audio and video calls while simultaneously taking notes i.e. noting clinical condition, writing prescription  and entering data concurrently. The platform has features to support event based customizable messages sent to patients & doctors.

Platform supports multiple channels for appointments such as miss-call, online (web portal), as well as through mobile application. Patients have the option of adding family members and booking appointments for them. Patients can share their live location with the doctor. Platform has customizable templates for the speciality history taking for the purpose of consultation (this is done at time of registration).

The platform has seamless queue management based on queuing algorithms and generates SMS and notifications (in-app notifications and alerts are also generated). Application has a module that sends personalised messaging and engagement content (Patients could see videos available on the platform as they wait for their appointment). Doctors can configure admin roles to manage their schedules..  

Doctors can have multiple formats of templates on which they can enter data using  a digital pen. There is also an option for virtual keyboard based data entry. It is integrated with proprietary EMR. The other notable features are configuration of templates, handwriting recognition and structured data conversion. The solution also claims to have an intuitive and attractive user interface. Platform supports writing prescriptions with basic requirements mandated by TPG guidelines that have E-signature and digital pen input. Web and mobile platform solutions are interoperable. Data entry is mainly  paper based with the use of a digital pen. 

It is claimed that the solution has integration of SNOMED CT for clinical finding, ICD-10 for diagnosis. Typed information is converted into text and in the back-end linked with codes using a dictionary (configurable as SNOMED CT, ICD10 or any standard).

Additional Information

The solution also ensures following features:

a) Kiosk

b) Proactive Patient engagement

c) Waiting room management

d) Digital pen

e) Missed call for appointment

Solution Maturity Level

a) TPG compliant:  3a

b) Feature complexity:  3b